Health officials urge vigilance on ticks

THE ISSUE: Ticks can transmit several diseases, including Lyme disease and Powassan virus to humans.

THE IMPACT: There were more than 4,500 reported cases of Lyme disease in Massachusetts in 2016, and some are bracing for a potential uptick this year.

Gerry Tuoti Wicked Local Newsbank Editor

A little bit of vigilance, and some bug spray, can go a long way in reducing the health risks associated with ticks, public health officials say.

“Anyone who spends time outdoors should be doing daily tick checks,” said Dr. Catherine Brown of the Massachusetts Department of Public Health. “The first step is remove it promptly. The best way is to use a pair of fine-tip tweezers. Grab as close to the skin as possible and pull firmly.”

Black-legged ticks, often informally referred to as deer ticks, can carry multiple diseases that affect humans. Lyme disease, by far the most common, can cause joint pain, fatigue, headaches and fever. It sometimes produces a rash around the tick bite. If caught early, the bacterial disease is very treatable. But if untreated, it can cause neurological problems, meningitis and severe joint pain.

A tick typically needs to be attached to a person’s skin for an extended period of time to transmit Lyme disease. Lyme can be diagnosed through a blood test and exam. Ticks, if preserved, may also be tested in a lab.

Another tick-borne disease, Powassan virus, is much more rare and is often more serious, sometimes producing dangerous swelling of the brain.

In light of predictions earlier this year that there would be high numbers of ticks this summer, Brown said tick populations are very local and are difficult to measure.

“From a public health perspective, it does not matter if we have a few more black-legged ticks this year or fewer,” she said. “Either way, we have a lot, and 33 percent of them are carrying Lyme.”

In a typical year, there are between 4,400 and 5,600 reported confirmed and suspected cases of Lyme disease in Massachusetts. Many cases don’t produce any symptoms, and the Centers for Disease Control and Prevention estimates as many as 90 percent of cases nationally go unreported.

Massachusetts has had 15 cases of Powassan virus since 2013, including two this year. The infections have resulted in three deaths.

The medical community is still gaining a better understanding of Powassan, Brown said. In 2013, the CDC provided funding to states to test for Powassan in people who had symptoms for West Nile virus or EEE but tested negative for the mosquito-borne illnesses. That year, there were nine confirmed Powassan cases in Massachusetts.

“That sounds like it was a really big increase, but we tested 150-200 people to find those nine cases,” Brown said. “We did that to raise awareness among healthcare providers so they would know Powassan is a risk in Massachusetts.”

U.S. Rep. William Keating, D-Mass., filed a bill in June that would direct the CDC to update tick-borne illness prevention and treatment procedures for providers, and provide additional training materials to healthcare providers.

On July 14, the House passed his amendment to a defense bill that will allow the Department of Defense to partner with medical researchers and universities to test for tick-borne illnesses. The amendment also allows the Department of Defense to award grants to universities to lower the cost of testing a tick for the general public. It currently costs an average of $50 to test a tick.

“According to the Centers for Disease Control and Prevention, over 30,000 cases of Lyme disease are reported each year. However, additional CDC research reveals the actual number of diagnoses could be as high as 300,000,” Keating said on the House floor. “And alarmingly, nearly 20 percent of people surveyed in areas with high incidence rates of Lyme disease were unaware that the disease was even a risk.”

Powassan needs further studying, but it seems likely that many people infected with the virus never present any symptoms, Brown said.

“But, obviously, it can be a significant illness and cause fatalities as well,” she said.

Other tick diseases in Massachusetts include anaplasmosis, babesiosis and borrelia miyamotoi. They typically cause fever and flu-like symptoms.

Health professionals recommend using tick and mosquito repellent, wearing long sleeves and long pants outdoors, and performing periodic checks for ticks on your body.

Pet owners may protect their animals from ticks and tick-borne illnesses with tick repellent products, such as special collars and dips.

It’s important to realize that if you get a tick bite, it doesn’t mean you’ll definitely get sick, and that it’s also possible to get bitten without ever realizing it, Brown said.

“Most people who have a tick borne illness can’t remember the tick that bit them and can’t report a tick bite,” she said.